PDF(Pubmed)
Abstract：
Background and Objectives: The term \"Juxtafacet cyst\" refers to both synovial cysts and ganglion pseudocysts associated with the lumbar facet joint. As conservative treatment for the juxtafacet cyst has a minimal effect, complete excision through surgery is considered the first choice of treatment. In this study, we retrospectively reviewed the clinical outcomes of percutaneous epidural neuroplasty for symptomatic lumbar juxtafacet cysts. Materials and Methods: We conducted a retrospective review of 34 patients with symptomatic juxtafacet cysts who visited a single institute from January 2010 to September 2023. Patients who received conservative treatment for at least 6 weeks but experienced no or insufficient effects were eligible for this study. After neuroplasty, a medical history check and neurological examination were performed during follow-up at 2 weeks, 1 month, 2 months, 3 months, 6 months, and once a year thereafter. Results: The pain improved for all patients to a VAS score of 3 or less immediately after neuroplasty; however, four of those patients (11%) had pain that worsened eventually to the same level as before the procedure and required surgery. The results showed that, regardless of cyst size, in cases with severe stenosis of the spinal canal, the outcome of neuroplasty was poor and often eventually required surgery. The cyst size was not associated with the procedure results. In addition, if the cyst was present at the L4-L5 level, or if diabetes mellitus was present, the likelihood of future surgery was significant (p-value = 0.003). Conclusions: Percutaneous neuroplasty showed a better success rate than other non-surgical treatments. In addition, severe spinal stenosis (Schizas grade C or higher), L4-L5 level, or diabetes mellitus produced a high possibility of surgery due to recurrence.
摘要：
背景和目的：术语“近面囊肿”是指与腰椎小关节相关的滑膜囊肿和神经节假性囊肿。由于保守治疗近突囊肿效果甚微,通过手术完全切除被认为是首选治疗方法。在这项研究中,我们回顾性分析了经皮硬膜外神经成形术治疗有症状腰椎并面囊肿的临床结果。材料和方法：我们对2010年1月至2023年9月在一家机构就诊的34例症状性并囊肿患者进行了回顾性分析。接受保守治疗至少6周但没有效果或效果不足的患者符合本研究的条件。神经成形术后,在2周的随访期间进行了病史检查和神经系统检查，1个月,2个月,3个月,6个月,此后每年一次。结果：所有患者在神经成形术后立即疼痛改善至VAS评分3或更低；然而，这些患者中有4例(11%)的疼痛最终恶化到与手术前相同的水平,需要手术治疗.结果表明,不管囊肿大小,在椎管严重狭窄的情况下，神经成形术的结局较差,通常最终需要手术治疗.囊肿大小与手术结果无关。此外,如果囊肿存在于L4-L5水平，或者如果糖尿病存在，未来手术的可能性显著(p值=0.003).结论：经皮神经成形术的成功率优于其他非手术治疗。此外,严重的椎管狭窄（SchizasC级或更高），L4-L5级，或糖尿病由于复发而导致手术的可能性很高。
